Department of Gastroenterology and Hepatology, Erasmus Medical Center-University Medical Center, Rotterdam, The Netherlands.
School of International Affairs and Public Administration, Ocean University of China, Qingdao, China.
J Infect Dis. 2023 Aug 16;228(4):391-401. doi: 10.1093/infdis/jiad034.
This study aims to comparatively analyze clinical features, treatment, and patient outcomes between the previous and the 2022 mpox (monkeypox) outbreaks.
Five bibliographic databases were searched for studies reporting clinical features, management, and patient outcomes of mpox. Systematic review and meta-analysis were performed.
In total, 73 studies were included in the systematic review, of which 33 studies were subjected to meta-analysis. Previous outbreaks substantially affected children, whereas the 2022 outbreak primarily affected male adults, of which 94.66% (95% confidence interval [CI], 88.03-98.95) were men who have sex with men. Furthermore, 72.47% (95% CI, 51.04-89.71) reported high-risk sexual activity and the overall human immunodeficiency virus (HIV) prevalence was 37.65% (95% CI, 30.09-45.50). Skin lesions remain the typical symptom; however, their anatomic distribution differed. Systemic manifestations were common, but rectal pain was unique to the 2022 outbreak. The estimated overall fatality during past outbreaks in Africa was 4.61% (95% CI, 2.39%-7.35%), whereas 6.34% (95% CI, 3.35%-10.10%) of patients from the 2022 outbreak required hospitalization. Antiviral treatment, in particular tecovirimat, has been prescribed for a subset of patients, but the efficacy remains inconclusive.
These findings are important for better understanding the disease and guiding adequate response to mpox outbreaks.
本研究旨在比较分析既往和 2022 年猴痘（猴痘）疫情的临床特征、治疗和患者结局。
检索了五个文献数据库，以获取报告猴痘临床特征、管理和患者结局的研究。进行了系统评价和荟萃分析。
共纳入 73 项系统评价研究，其中 33 项研究进行了荟萃分析。既往疫情主要影响儿童，而 2022 年疫情主要影响男性成年人，其中 94.66%（95%置信区间[CI]，88.03-98.95）为男男性接触者。此外，72.47%（95% CI，51.04-89.71）报告有高危性行为，总体人类免疫缺陷病毒（HIV）感染率为 37.65%（95% CI，30.09-45.50）。皮肤损伤仍然是典型症状；然而，其解剖分布不同。全身表现常见，但直肠痛是 2022 年疫情的独特表现。既往非洲疫情的总体病死率估计为 4.61%（95% CI，2.39%-7.35%），而 2022 年疫情中有 6.34%（95% CI，3.35%-10.10%）的患者需要住院治疗。抗病毒治疗，特别是特考韦瑞，已被用于治疗部分患者，但疗效仍不确定。
这些发现对于更好地了解该疾病并指导对猴痘疫情的充分应对具有重要意义。
